When it comes to pay, which generation of docs has it best? 2024’s most compelling millennial compensation trends

By Meghan McCallum | Fact-checked by Barbara Bekiesz

Published December 20, 2024

Key Takeaways

Medscape just released results of their annual survey of 7,000 US practicing physicians across 29+ specialties about a number of topics, including compensation.^[]

We analyzed the just-released 2024 report so you don’t have to—here’s what we found.

Overall, pay is up—but not for everyone

For the 2024 compensation report, Medscape defined millennial respondents as those under age 40. Compensation for doctors in this generation was up 4% overall in 2023 compared with 2022. This increase was greater for primary care physicians than it was for specialists, who saw little change. Based on place of employment, average compensation was highest for single-specialty private practice at $358K, with hospital at $339K and outpatient clinic at $278K.

While these numbers look good for PCPs, some primary care respondents noted that they are paid less and/or unfairly compared to specialists. “Very little value is placed on primary care,” one said. Additionally, gender pay gaps persist for all physicians, as was noted in Medscape’s 2023 and 2022 reports. A 24% gender pay gap, favoring men, was calculated for millennial physician respondents.

Unfortunately, incentive bonuses have declined for millennial physicians. The 2023 report showed an average bonus of $51K, while the average in this year’s report was down to $39K.

Midwest pays best; Northeast falls below

Location also plays a role in millennial physicians’ compensation. In the Midwest, the highest-paycheck region, millennial respondents earn an average of $343K. Meanwhile, the lowest-paid millennials are in the Northeast, with average compensation of $300K.

Despite these increased average incomes, 51% of millennial physicians reported that they don’t feel fairly paid for their work. This is a slight increase from the 2022 report, where 46% of this group felt underpaid. These numbers were similar for older physicians: over 50% of respondents ages 50-54 and 55-59 reported that they felt underpaid as well.

When it comes to specialties, certain areas had higher rates than others of compensation satisfaction.

The most satisfaction was reported among psychiatry, anesthesiology, dermatology, and emergency medicine, with 60% or more of each of these categories expressing they were happy with their compensation.

Millennials' chief complaints

Millennial respondents spoke up on specific issues with their work and compensation. One referred to their job responsibilities as “an assembly line,” while others referenced burnout.

School debt was also cited as a source of dissatisfaction. The specialties with the highest occurrence of student debt, all over 50%, were family medicine, OB/GYN, orthopedics, and internal medicine. “The average minimum monthly payment doctors make is $2,275,” the report said.

Chief complaints haven’t changed recently—in the past 3 years’ reports, millennials cite difficult patients and long hours among the most challenging parts of their work. “Dealing with managing relationships of all types: difficult patients, difficult staff, difficult community partners, and hospital admin,” said one respondent.

Is pay the most important factor? Maybe not

Although many respondents expressed dissatisfaction with their compensation, a high percentage—70%—of the millennial physicians said that compensation was “at most a minor factor” in their specialty choice. Similarly, compensation was the main factor for only 3% of physician respondents over age 40.

Millennial physicians named helping others as one of the most rewarding aspects of the job. “The opportunity to profoundly impact individuals’ lives through compassionate care and evidence-based treatments is immensely fulfilling,” said Sham Singh, MD, a millennial holistic psychiatrist at WINIT Clinic in Santa Monica, California.

Despite compensation complaints, 68% of millennial respondents would choose a career in medicine again. This number has decreased somewhat in recent years, from 76% in the 2021 report.

Among older physicians, the proportions who would choose medicine again are even higher: 73% for ages 55-59, 76% for 60-64 and 83% for 65-69.

Millennials were more likely to be satisfied with their specialty than with their place of work. In this group, 84% said that they would choose the same specialty, while only 32% responded that they would choose the same practice setting.

Moonlighting and new technologies present intriguing opportunities for millennial physicians. “Technologies like telemedicine and virtual assistants also enable young doctors to find newer models of moonlighting than previous generations had,” the report states.